Imagine a world where healthcare is accessible and affordable for everyone. Sounds idealistic, right? But it's a goal the World Bank Group is actively pursuing, aiming to reach a staggering 1.5 billion people by 2030. And the progress made so far is genuinely inspiring. But here's where it gets controversial... achieving this ambitious target requires a fundamental shift in how countries approach healthcare.
As of today, December 6, 2025, significant strides have been made. Fifteen countries have stepped up and introduced what they're calling "National Health Compacts." Think of these as detailed five-year plans, designed to overhaul their healthcare systems. These compacts aren't just wishful thinking; they're concrete roadmaps focused on three key improvements: expanding primary healthcare access, making healthcare more affordable for everyone, and fostering economic growth through job creation within the health sector.
Since the initial announcement of the 1.5 billion goal in April 2024, the World Bank Group, along with its partners, has already helped bring quality, affordable healthcare to 375 million people. That's a huge number! Currently, they're collaborating with approximately 45 countries to implement proven strategies for strengthening primary care. These strategies not only improve health outcomes but also generate employment opportunities across various sectors, including healthcare workforces, local supply chains, and related industries.
This progress is particularly crucial given the challenges many countries face. Aging populations, the increasing prevalence of chronic diseases, and persistent financial constraints are putting immense pressure on healthcare systems worldwide. The recently released 2025 Global Monitoring Report highlights the severity of the situation: a shocking 4.6 billion people lack access to essential health services, and 2.1 billion face financial ruin due to healthcare costs. These figures paint a stark picture and underscore the urgent need for long-term, coordinated reforms to build more resilient and equitable healthcare systems.
According to Ajay Banga, President of the World Bank Group, "Strong primary health systems do more than safeguard health—they support jobs and economic opportunity. Countries are stepping forward with clear priorities, and we are working alongside them to deliver practical solutions at scale. When efforts align behind what works, impact grows.”
So, what exactly are these National Health Compacts? In essence, they are country-led roadmaps endorsed at the highest levels of government. During a forum in Tokyo, the 15 participating countries presented their compacts, demonstrating a commitment to aligning Health and Finance Ministries behind measurable targets. These targets provide a framework for coordinated action and guide support from development partners, ensuring resources are directed toward country-led priorities. The reforms within these compacts center around three main objectives:
- Expanding the reach and quality of primary care: This involves bringing healthcare services closer to people, especially in underserved communities.
- Improving financial protection: Ensuring that people don't face financial hardship when seeking medical care.
- Strengthening the health workforce: Investing in training, recruitment, and retention of healthcare professionals.
Countries are committing to various initiatives, including mobilizing new funding, growing and digitally enabling their health workforce, modernizing healthcare facilities, expanding insurance coverage, and leveraging digital tools to improve service delivery.
Here are some concrete examples of what countries are doing:
- Investing in connected, service-ready facilities: For instance, the Philippines is working on digitally connecting health facilities nationwide to improve communication and coordination. Uzbekistan is digitizing administrative processes, aiming to reduce workloads by 30%. Sierra Leone has an ambitious goal: ensuring every citizen can access quality primary care within five kilometers. To achieve this, they're constructing 300 new facilities and equipping 1,800 with solar power and digital connectivity.
- Diversifying primary care delivery: Bangladesh is expanding multi-platform primary care models, supported by updated regulations and digital tools. Indonesia is scaling digital primary care, connecting over 600 facilities to hospitals through telemedicine, effectively bringing services closer to patients' homes. And this is the part most people miss... the use of telemedicine can dramatically improve access to specialists in rural areas.
- Digitally enabling and strengthening the health workforce: Ethiopia plans to equip at least 40% of its primary health centers with digital tools to support clinical care and workforce management. Saint Lucia is investing in a skilled, digitally enabled workforce and modernizing regulations and education through regional cooperation.
- Removing financial barriers to care: Kenya is committed to doubling public health spending over five years to reach 5% of GDP. They also aim to expand social health insurance coverage from 26% to 85%, with full subsidies for vulnerable populations. Morocco is extending mandatory health insurance to an additional 22 million people.
- Boosting regional manufacturing of health products and technologies: Nigeria is taking steps to become a hub for pharmaceutical and biotech innovation. They plan to train 10,000 professionals, create Centers of Excellence, and offer tax incentives to encourage local production of vaccines, medicines, diagnostics, and health technologies.
Achieving the 1.5 billion goal hinges on coordinated support from various stakeholders. To help countries advance their National Health Compacts and broader reforms:
- The World Bank Group, Gavi (the Vaccine Alliance), and the Global Fund have announced aligned financing, including $2 billion co-financed with each institution.
- Philanthropic partners, working through the Global Financing Facility and the Health Systems Transformation and Resilience Fund, are working to mobilize up to $410 million of philanthropic support.
- Seed Global Health is collaborating with compact countries to build capacity and provide support for assessments, planning, and policy development, with a focus on advanced health workforce development.
- Countries like Japan and the United Kingdom are providing technical assistance to help countries implement their reforms.
To facilitate knowledge sharing, Japan, WHO, and the World Bank Group have launched the Universal Health Coverage Knowledge Hub, which will provide countries with practical, evidence-based solutions and opportunities for peer learning. This hub will be invaluable in helping countries avoid common pitfalls and adopt best practices.
The Universal Health Coverage High-Level Forum, a collaborative effort between the Government of Japan, WHO, and the World Bank Group, brought together key players, including health and finance ministers, business leaders, philanthropies, global health agencies, and civil society organizations. It served as a platform for sharing experiences and forging partnerships.
The countries that have launched National Health Compacts are: Bangladesh, Egypt, Ethiopia, Fiji, Indonesia, Mexico, Morocco, Nigeria, Philippines, Sierra Leone, Syria, Tajikistan, Uganda, Uzbekistan, and Zambia.
But here's a question for you: Are these National Health Compacts truly the most effective way to achieve universal healthcare? Could there be alternative approaches that might yield even better results? What role should technology play in bridging the healthcare gap? And how can we ensure that these reforms truly benefit the most vulnerable populations? Share your thoughts and opinions in the comments below! Let's discuss and explore different perspectives on this critical issue.
